For many people, having a sweat-drenched head and body after a workout is considered a hard-earned sign of getting into or being in shape.

However, for many black women, such perspiring exercise is not inspiring at all, especially if it means sweating through or later washing away the chemical treatments from a high-dollar visit to the hair salon.
A study by Wake Forest Baptist Medical Center has found that balancing fitness and hair care is more than a lifestyle choice for black women.
Researcher Dr. Amy McMichael said it can contribute to poorer health in a group already identified as having the highest rates of being overweight or obese. The U.S. Department of Health and Human Services' Office of Minority Health reports that about 80 percent of black women are overweight or obese.
The latest update on McMichael's six years of research is online at Archives of Dermatology, a network publication of the Journal of American Medical Association.
McMichael, a professor of dermatology at Wake Forest Baptist, specializes in hair and scalp diseases, ethnic and pigmented skin diseases, general dermatology and skin care.
"I see a lot of African-American women in our clinic and had noticed how many of them are overweight," McMichael said. "This puts these women at risk for hypertension, diabetes and other serious problems."
McMichael said the issue is not limited to just black women, but can affect Hispanics and teenagers of all races.
McMichael's research found that 40 percent of female patients ages 21 to 60 cited complications with their hair care and maintenance as the reason they do not exercise or exercise less than they would like.
Choosing exercise can be costly given that having hair relaxed can range from $60 to $75, while a weave can range from $125 to $1,500. That's not including $150 to $200 for labor.
It typically takes about two to three hours to have hair relaxed and styled and about six hours for a weave. Both need to be maintained or touched up every six weeks.
"Because many African-American women with coarser hair use either heat straighteners or chemical products to straighten their hair, they can't just easily wash their hair after exercise because of its fragility," McMichael said. "Over-washing fragile hair can make it break off easily."
Of those patients who exercise frequently, 50 percent have modified their hairstyle to make it more exercise friendly, the study found.
"Somebody might say, 'Oh, just cut your hair,' but that does not always make sense," McMichael said. "We have to figure out better ways, such as innovative exercise techniques, to address this issue."
Dealing with exercise
Trying to stay fit and keep her hair-salon hairstyle had become a source of frustration for Beverly Robinson, a banking officer with Abbot Downing, an ultra high-end wealth-management group of Wells Fargo & Co.
Robinson teaches fitness classes at the Gateway YWCA and also participates in Black Girls Run!, a local chapter of a national running group.
"I routinely had my hair relaxed and styled at the salon," Robinson said.
"When I went to the gym and worked out, the style was negated due to the sweating and heat from blow dryers and curling irons. The back and forth became taxing and expensive and was also detrimental to the health of my hair, leading to breakage and damage."
Robinson said her breakthrough came in 2011 after discussions with her daughter, Carmen Robinson, a fourth-year medical student at Wake Forest Baptist School of Medicine who went natural with her hair in 2008. Carmen Robinson has received dermatology treatment from McMichael.
"With all the awesome natural products in the market, I have been able to work out diligently and keep my hair healthy and gorgeous," Beverly Robinson said. "I've been able to rock every style I want, whether curly, flowing or kinky.
"In my line of business as a wealth manager for a national financial institution, I have not missed a professional beat -- often complimented for my healthy mane and stylish hairdos. I've vowed never to return to chemicals."
McMichael and Beverly Robinson say it's understandable that black women would not want to wash out their hair-care investment quickly.
"In today's economy, it is indeed a challenge to find a balance for a healthier lifestyle," Robinson said. "Many may not and have not been able to afford gym membership or affordable child care or elderly care for their family members.
"But do you think they realize the cost to their short- and long-term health by not exercising, particularly if they are vulnerable to diabetes, high blood pressure and other diseases and conditions?
"I think this surge is attributable to the witnessing of so many deaths occurring amongst a younger generation."
Deep-rooted issue
McMichael and Beverly Robinson say the fitness vs. hair care challenge is a deep-rooted one for black women that often surfaces in childhood and leaves them juggling their hair care with family, finances and social life.
"Professional establishments and media have always dictated that hair should be flowing in order to fit into a mainstream mold," Robinson said. "Locked hair, afros and naturals have traditionally been frowned upon as unkempt, unattractive and unprofessional."
Many women are supporting families and can't afford to lose their job because of a "hair code.
Karen Hixson, director of Salem College's exercise science program, said swimming has prompted the most complaints about hair care by women of all races. Hixson has been involved with exercise science for 30 years.
"I actually changed a class from three times per week to two times per week once -- with longer time in the pool each class -- because the women were much happier with getting their hair in the pool that way," Hixson said.
Hixson said some women adapt by wearing a shower cap. "It does not mess up the hair like a swim cap does, and there are some fun-fancy options in shower caps," Hixson said.
Hattie Taylor, preventive health coordinator at Gateway YWCA, said she has "encountered a larger percentage of women ages 18 to 45 who complained about damaged hair from exercise."
Older women seem less concerned, she said; many in that age group wear natural hairstyles.
Committed to health
Robinson also teaches occasionally a fitness class for the Sisters Together Empowered for Prevention and Success (STEPS) program at Winston-Salem State University. She typically has 60 to 80 women in a session, mostly between the ages of 35 and 65. There are about 300 participants overall.
"Most of the ladies have seen the decline in health within their families and have vowed to change their lifestyles up to and including eating habits and hair care," Robinson said.
Dr. Cynthia Williams Brown helps coordinate the STEPS program as its principal research investigator. She also serves as chairwoman of WSSU's human performance and sports science department.
"We are seeing more women in our community choosing to go natural with their hairstyle, partly because of fitness and largely because it is a more cost-effective way to manage their hair," Williams Brown said.
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